Director, Performance Suite Analytics

Overview

Your Future Evolves Here

Evolent partners with health plans and providers to achieve better outcomes for people with the most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of a fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent values work/life balance, flexibility, and autonomy, and prioritizes diversity and inclusion as core to the business. Join Evolent for the mission. Stay for the culture.

Who You’ll Be Working With

The Director, Performance Suite Analytics utilizes and develops analytic tools to solve complex business challenges and support decision making that can have a considerable impact on organizational performance and patient health. This role supports capitated risk and value-based strategy development, medical cost management activity, medical economics activity, and a variety of internal operations functions; partnering with Business Development, Product Strategy, Finance/Accounting, Actuarial, EDWBI, Clinical, Performance Solutions and Partner Delivery.

What You’ll Be Doing

• Leading the analytics partnership with Business Development & Product teams in developing the strategic approach for innovative and in-demand value-based care pursuits
• Serving as a strategic partner of our analytics capabilities and processes related to the development/underwriting of capitated risk proposals including cost & use projections, trend selection/development, and estimation of Evolent’s ability to reduce cost and improve quality
• Leading a team in the analysis and interpretation of cost and utilization data (medical and pharmaceutical) to explain potential upside/downside risks of a given arrangement/proposal
• Partnering with actuarial, finance, and analytics teams to incorporate new products and strategy innovations into existing analytical models and reporting frameworks
• Developing analytical models and synthesizing complex analyses into succinct presentations for internal & external stakeholder buy-in
• Assisting in the development of budgets and forecasts for each new business relationship and packaging key insights for tracking performance
• Collaborating with partner departments to establish best practice processes and efficient workstreams from end to end of the proposal process
• Using programming skills to explore, examine and interpret large volumes of data to complete deliverables with minimal oversight
• Leading and facilitating interaction with customers in a manner that fosters trust, expertise and cooperation
• Collaborating with internal/external business customers to understand their problems and objectives, solve business questions, and help them achieve goals by performing statistical analysis and creating data reports/dashboards
• Managing, mentoring, and coaching analysts
• Setting clear goals and objectives and using metrics to measure performance while holding staff accountable

Qualifications (Required)

• Bachelor’s degree, preferably with a quantitative major or healthcare focus
• At least 5 years of professional experience in claims-based healthcare analytics with a payer, provider, vendor, managed care, or related healthcare setting
• Extensive knowledge of healthcare claims; differences between institutional vs professional billing and various sites of care/service
• Experience with healthcare reimbursement methodologies and calculations (DRGs, Revenue Codes, CPT Codes, RVUs, APMs, bundled payments, etc.)
• Advanced or higher proficiency in Microsoft Excel
• Advanced or higher proficiency in SQL or SAS
• Moderate proficiency in Microsoft PowerPoint
• Experience in data mining, advanced/statistical analysis, and data manipulation
• Knowledge of health insurance financial business cycle, healthcare quality reporting, and benchmarking
• Ability to communicate clearly with diverse stakeholders; translate between business needs and analytical needs
• Exceptionally strong analytical abilities with a track record of identifying insights from quantitative and qualitative data
• Prior people management experience
• Ability to work independently with limited oversight

Preferred (Finishing Touches)

• Master’s Degree with quantitative or healthcare focus
• Experience in Utilization Management/Clinical Vendor Management
• Knowledge of healthcare underwriting methodologies
• Familiarity with value-based care and utilization management
• Understanding of data systems and adaptability to data architecture changes
• Experience with Python, R, SAS, Hadoop, AWS, ArcGIS
• Experience with BI tools (Power BI), Visual Basic, and PowerPoint

Technical Requirements

We require that all employees have high-speed internet at home (10 Mbps or faster). Specifically for call center employees, the ability to plug in directly to the home internet router. These requirements may change with office reopenings.

Equal Opportunity and Accommodation

Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need reasonable accommodation to access the information provided on this website, please contact for further assistance.

To comply with HIPAA security standards (45 C.F.R. sec. 164.308 (a) (3)), identity verification may be required as part of the application process. Reasonable accommodations are available upon request.

Salary and Benefits

The expected base salary range for this position is $130,000-145,000. This position is eligible for a bonus component based on performance. Evolent offers comprehensive benefits to qualifying employees. Compensation is based on skills and experience and may vary.

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